Restriction Rant

I have finally figured out that I am one of the (few, I think...) Bandsters who never experience "true" restriction: you know, the kind we were all hoping for when we had this done, the kind that says "you're full!" just before you PB, the kind that controls your portion size for you. Also, the Band is supposed to make it darn-near impossible to eat bready/starchy foods and even some uncooked vegetables. Nope. Not even now when I am way too tight do I have those limitations. I don't eat bread now because I don't want to, and it CAN get stuck, but it's not on the "never list".

I do have more restriction than being totally Band-less, sure - but it's not enough to get me to lose the weight. I do have a limit to how much I can eat, and will PB if I eat more than I should. Unfortunately, in order to lose, I apparently need to eat much much less than my Band will "let" me.

In search of this elusive restriction, I have gotten myself too tight. I really need to go in for an unfill. I'm sad about this, because it's been so hard to lose the weight, but I know it's the right thing to do - having stomach acid wash up through my esophagus a few times a day can't be healthy long-term.

I know, I know, "the Band is just a tool". I hear ya', and I knew that going in. But if we admit it, don't we all wish for it to be easy enough? I mean: you watch the quality of your food, and the Band watches your portions for you and then, voila! - all the weight is gone? I know the last 20 pounds are supposed to be hard, but the last 90?

I really didn't want to have the Band AND be on a strict diet, too. Especially reading some people's wonderful accounts of how easy it's been for them to lose the weight, and the Band was just that last thing they needed. I know the Band has been good for me, and it DOES really help me stay full between meals - a very critical ingredient in diet-adherance. But, I was really hoping it wouldn't be so hard - not this early in the journey anyway (weight-wise).

At least now I know - no matter how tight I am, it won't be enough to lose weight without dieting. Not the truth I wanted, but the truth nonetheless.

Budging and Not Budging

Well, cutting my portions in half is finally working. The scale has been at 263 for the last 4 days, so I’ll finally take that number as “real”. It has taken a very long time to get here – especially since I already blipped here once, but I'm glad I finally made it.

I'm continuing with the brisk walking. It alone didn't seem to make a shred of difference on the scale, sadly, but I know in the long run it will be very important. I feel stronger, and I know how much my body loves it. I really really didn't want to go today. I was feeling crummy - muscles hurting, tired, blah - but went ahead and did it anyway because it was Wednesday by golly, and on Wednesday I walk. I did as always: start by telling myself I only have to go 20 minutes, and ended up going 40. I felt so much better after, it was uncanny. My body truly craves exercise - I have to make it a priority, whether or not it affects the scale.

On another note, I saw a message tonight on a board I read about a woman who just got pre-approval for her Band from my same insurance company. The one that said they didn't pre-approve. The one that denied me 3 times. I'm still a bit bitter. We're working on it as best we can, but at the same time we're having to make payments - to a collections agency. That makes me feel like total crap. We've always had good credit: to be paying a collections agency feels scary and failure-ish. I don't like to think about it because I'm supposed to think Happy! Positive! thoughts, but I think all these negative experiences have soured me toward my Band (and my clinic, and my insurance company). I'm still praying and working on it, hoping it will come out all right in the end.

Stepping it Up

I had an appointment with my beloved PCP today. With all of my health problems, I was amazed that I hadn't been in to see her since August. Sadly, I have only lost 3 pounds since then. *sigh*

She is so awesome and is the one who encouraged me to get this surgery in the first place. She truly cares about me and takes time to listen to me. She is going to help with the insurance debacle, and she also set me a goal: Lose 10 more pounds by January 4. It's totally doable, but is going to take some stepping up on my part- both with food choices and with making more frequent appointments with my clinic. She encouraged me to move my other health stuff to the side for now and put all my focus into the Band right now.

She affirmed me and we did celebrate that in this year of big stressors, I have lost weight, not gained. She listened to all my frustration with the clinic (ultra-conservative fills, and unsupportive staff) and repeated some advice she had given me early on that I had fully intended to follow, yet didn't: go in to the clinic every 3 weeks, no matter what. I'm not sure why I didn't follow through with that - I think it might be because I had 3 visits in a row where the nurses were shaming and unkind and then here is the insurance problem that they've exaserbated, blaming me all the while. This kind of poor support and shaming mixed with my deep-seated issues (nobody gets to be 300+ pounds unless they have issues, trust me) shut me down. I also continue to struggle with choices and I think I was afraid to go in and hear the messages that I needed to hear about nutrition and focus and working on this weight loss in a determined way. I needed to be told in an empowering way. My clinic may not be able to do that, but my PCP does. It's sad that I can't get emotional support from my clinic, but I need to stop feeling bad about that and start seeking that support other places. I need to use the clinic as another tool.

It's time for me to step up: to not let the messages from my clinic dictate how I feel, to continue to work through my issues and not turn to food, and to work harder on making really good choices. The band can't do all the work. Not even close. I have to do my part, too.

Now I have a challenge - watch me come through!

A Most Un-Ladylike Rant

there was no urge she could not suppress
From Anne Taintor

Why I am I not writing about my Lap-Band? Um, well, it’s because I’m FURIOUS. You see, I’m not so good at being furious. Even here on the internet, where the harshest yelling is just CAPS LOCK, I have a bit of trouble showing my anger. See, I was raised to be quiet, polite and unobtrusive. Even though it was okay for my dad to explode on a regular-yet-unpredictable basis, that kind of behavior was totally unacceptable from my pretty little head. I’ve worked through this with humor and with lots of therapy, but I still feel quite a bit uncomfortable about being angry. It isn’t ladylike. It isn’t prudent. It isn’t logical. Of course, if I had learned to yell or vent or anything instead of stuff my emotions I’d be a much healthier individual.

But since I still often try to tap-dance around the rage thing, I’ve tried to be nice here - to see the ways that I’m failing (and yes, there is always room to look at that area and make improvements). But I can no longer escape the reality of my overwhelming feelings. I’m absolutely furious at my clinic. My insurance claim was rejected again (remember the first 2 times it was rejected out of hand because my clinic NEVER BOTHERED TO SEND THE INFORMATION TO MY INSURANCE, even though I was told repeatedly they had). Now my clinic sent them 70 pages of faxes, but it’s not what my insurance needed, and from my review, much of what they sent was incorrect. For example, they say I have diabetes and hypertension. Um, huh? I have no idea where they pulled that information out of. Maybe all their clients develop diabetes from how incredibly sweet they are BEFORE surgery and then develop hypertension from how incompetent and unhelpful they are AFTER surgery?

I have spent HOURS on the phone and have gotten virtually nowhere. Now I’m being billed by the clinic AND the facility and everyone is treating me like I have leprosy. (Perhaps I do? Perhaps I should shower more often?) My clinic claims they’ve never had this much trouble with my insurance before. I find that incredibly hard to believe, seeing as how their incompetence so far has been stunning.

Add to the insurance woes the fact that I STILL DO NOT HAVE SUFFICIENT RESTRICTION and I’m a very very unhappy little girl. Yes, I’ve lost another few pounds. The scale is now bouncing between 276-279 and it’s that time of the month, so I’ll commit to a real number next Friday when things balance out with hormones and bloating and all that other TMI. I’ve also been under an incredible amount of emotional stress, so I should be glad that I’ve been able to lose weight under the circumstances (instead of gaining 20 pounds + like I have before). Unfortunately, the lack of restriction and inability to get in for fills in a timely fashion, combined with the possibility that I may end up with a $20,000 bill partly due to the incompetence of my clinic is only adding to my stress level.

So, 2 pounds in 6 weeks. I’m unhappy. I’m very frustrated. And I put off writing about it because it’s not very ladylike to rage and fume.

Here’s what I want to say: RUN. Don’t go to my clinic. They are so sweet and supportive BEFORE you have your surgery. THEN they jerk you around. You can’t get in for fills. When you do, they are way too conservative. It will take you 6 months to get to the right restriction, and they will lecture you on alternate visits about things you already know – one time they will commiserate with you and promise to get you at the right fill level, and the next visit they will shame you for creating all your own issues and tell you that you have to do all the work, not the Band. They will not file the proper documents with your insurance. They will write erroneous information in your file, causing your insurance to distrust you for being late, and for lying. They will tell you that every other insurance claim goes just fine and only you are being difficult. They will make you regret you ever bought their lies, had surgery, and got a freaking Lap-Band in the first place.

More Insurance Seething, and a Bit of Hope

I’m still pretty ticked off at my clinic. The last woman I talked to (“C” of the Latest Installment of the Insurance Debacle) was very sweet. However, each time I have called her back, she has seemed momentarily surprised to hear from me. She looks into the computer and promises to get on it “first thing tomorrow morning”. Uh, isn’t that what you told me last time?

The kicker is, when I talked to C last Wednesday , she looked in my file and let it slip that IT DIDN’T LOOK AS IF ANYONE HAD ACTUALLY SEND MY INSURANCE THE PAPERWORK! This was the paperwork that had to be sent after the expected first rejection. The paperwork I called and followed up on and was assured was sent. She grilled me on whom I had talked to (I usually write it down, but because there are only 3 of them, I hadn’t). After a second, she started to backtrack and say “I’ll get right on this”… you know what’s coming next… “first thing tomorrow morning”.

At least she called me two days later to say the paperwork had been sent off. NO WONDER I was rejected on the basis of “insufficient documentation”. There was NO documentation. I’m still seething. A little.

Today I called my insurance company and talked to the sweetest lady (yes, I got her name and call reference numbers). She pulled everything up, noting that the FIRST information they had received was not until AUGUST 2^ND. Seethe. Seethe. She did the magic electronic paperwork thing and said “I’m sending this off to corporate right now. Let’s get this paid for you – this is a lot of money!” I was swooning at this point. I got reference numbers, AND a time frame: 15-21 days.

I’m ticked off at my clinic – I knew I’d be rejected the first time, but the second one gave me a panicky shock. I knew we did all the paperwork right, but it’s still at the whim of the insurance company whether they’ll approve me. I feel like I went through a week of panic and not sleeping based on erroneous information and incompetence – of course the insurance denied the appeal – they had NO INFORMATION!! They now have 60 pages (!) of information. I hope that will be enough.

I should’ve called my insurance company a month ago, but I was assured by my clinic that everything was being taken care of. I know, I know, I learned my lesson!

Thankfully, I have hope now that my claim may be approved. Now that they have actual information and all.

$1176 Per Pound

I'm still angry and frustrated about my weight and the Lap-Band.

The last fill finally brought me the first restriction EVER. It helped me not eat between meals, but not to eat less at meals. I am choosing carefully to eat less. I NEVER get the "soft stop" or "hard stop" that Bandsters are supposed to have.

The scale moved down from 284.5 to 281.5. Down is good, but 3 pounds in 7 weeks at the beginning of my journey is NOT what this was supposed to be about.

I'm ticked off at my clinic, especially. For encouraging me to go ahead and trust the insurance process...For being so slow and over-cautious with fills...For not having enough nurses to service all their new patients (I can't get in for another fill until AUGUST freakin' 8!!!!!!!)...I'm feeling like I was sold an expensive service that is very lucrative for them and was dropped like a brick when I actually needed the help.

This surgery hasn't been worth $100 so far, let along the NINETEEN THOUSAND PLUS that my insurance is charging me now.

And the weight seems to have jumped back up to 284 in one day. Maybe due to all the VicOdin I've had to take? I don't know. I've been eating so little that I've been feeling faint. It feels like the only thing I can do at this point, and it still doesn't work.

This is ridiculous. Why the hell did I have this surgery? I could've just spent the money on yet another diet scam without having my body cut open and my bank account depleted.

I am raging mad. I have two big things I am working on in my life right now: lose weight, and figure out a treatment plan for the fibromyalgia. Neither one of them is going anywhere, despite great effort on my part.

Every facet of life feels like a sick, cruel joke.

Weight Loss Will Cure All Your Problems - NOT

Running low on spoons today
Originally uploaded by Leah Smith mypinktoes.

I have fibromyalgia, which means that on any given day, I hurt all over. Sometimes a lot, sometimes a little, but every day I’m in some sort of pain. It is mainly concentrated around my hips, and the theory is that although FM is not necessarily caused by a traumatic injury or motor vehicle accident, such events can bring out FM. I was in a serious car accident in 1991. The lap belt saved my life, but did lifelong tissue damage and since then I have been in pain every day.

And if one more person tells me that they think all this mythical-achy-stuff is going to *poof* magically disappear when I reach my goal weight, I may either throw a bottle of painkillers at them (not likely, but tempting), or (more likely) burst into tears. I’m in tears now with the weight of this dilemma – when people say that they hope my pain will disappear when I lose my weight, they are blaming all the pain on me. They are saying “you are in pain because you are fat.” I weighed 190 pounds when I was in my accident in 1991. I’ve been in pain at every weight I’ve held since then– from 180 pounds all the way up to 312. I have other pains that are clearly related to my weight – like my creaky knees, sore heels, and lower stamina for some activities. But the constant achy pain and the debilitating fatigue are unfortunately here to stay. The pain is NOT MY FAULT. I have to tell myself this over and over again. In my house growing up, most everything was my fault, so I’ve learned how to blame myself for everything. I did not bring this pain on myself, I did not ask for it, and God is not angry with me. I am still in therapy and constantly reminding myself of these things. Please stop making it even harder.

I’m cranky today. I’m in a lot of pain. I wish this was not one of the main narratives of my life. But it is. With God’s grace and help I will learn how to incorporate this narrative into the cohesive story of my life.

The photo is a reference to Spoon Theory, a very helpful analogy of what it’s like to live with chronic pain.

[This is snipped from a longer post at my other blog.]